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A recent history of ‘whistle-blowing’ in the NHS

The announcement earlier this month (October 2011) that NHS staff who raise concerns about poor patient care will be protected in the future has been expected for quite a while.

Recent cases involving ‘whistle-blowing’ – the term given to workers voicing concerns regarding colleagues and/or working practices – have illustrated how problematic it can be for medical professionals to share their worries.

This is a reassuring safety net but it is far better that an environment can be created so that health care workers can identify concerns before they compromise patients’ well-being and create the need for compensation.

This is one reason why Health Minister Andrew Lansley has announced changes to the NHS Constitution which will be enshrined from early in 2012.

The changes will introduce:

•An “expectation” that staff have a responsibility to raise concerns “at the earliest opportunity”

•A promise that NHS organisations must support staff and ensure that concerns are fully investigated

•The provision that someone independent of the relevant team should conduct the investigation

•“Clarity” concerning the legal right of staff to challenge a workplace’s safety record or identify malpractice “without suffering any detriment”

Commenting on the additions to the constitution, health minister Andrew Lansley said: “The first lines of defence against bad practice are the doctors and nurses doing their best to care for patients. They need to know that they have a responsibility to their patients to raise concerns and when they do so, they should be reassured that the government stands full-square behind them.”

There have been several high-profile incidents involving NHS whistle-blowing which are likely to have influenced Mr Lansley’s amendments to the constitution.

April 2009 – The Nursing and Midwifery Council (NMC) struck off ‘undercover nurse’ Margaret Haywood. Ms Haywood exposed concerns over poor standards of care at the Royal Sussex Hospital in Brighton. The NMC insisted that the nurse had been struck off not for whistle-blowing but for breaching confidentiality rules by filming staff without consent. She was re-instated in October 2009.

September 2009 – Three nurses (Jennie Fecitt, Anne Woodcock and Felicity Hughes) take NHS Manchester to a tribunal alleging that they were not offered sufficient protection after they voiced concerns about a work colleague’s qualifications.

The accused worker later admitted exaggerating his qualifications to colleagues but not to his employer. The judge in his summing up mentioned that the worker’s apology regarding this had satisfied his employer.

While all the nurses involved in the allegations continued working, a court was told that a “poisonous atmosphere” developed at the NHS walk-in centre in Wythenshawe with workers divided into factions.

Two of the whistle-blowers were re-deployed by bosses while the third, an agency worker, was not offered any more shifts.

The Court of Appeal judge, while expressing “an amount of sympathy” with the whistle-blowers, found against them.

October 2011 – Mid-Staffordshire Foundation Trust worker Helene Donnelly told a public inquiry that she was physically threatened by colleagues after voicing concerns about standards in the A & E department.

Such was her fear that after finishing a night shift she would ask a family member to collect her from work because she was too afraid to walk to her car in the dark on her own.

Conclusion

It is hoped that the new additions to the NHS Constitution will make health care professionals more willing to raise their concerns.

Research conducted by the NMC in August 2010 found that a climate of fear about voicing worries still prevails.

Two-thirds of health care professionals thought that whistle-blowers following the draft legislation which was the basis for the new constitution amendments would still face “significant barriers”.

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